title: Occupational rhinitis in damp and moldy workplaces.
abstract: BACKGROUND
  Numerous studies confirm the association between exposure to indoor air dampness and molds and different health outcomes. Of these, upper respiratory tract problems are the most commonly reported work-related symptoms in damp indoor environments. The aim of this study was to describe a clinically investigated patient series with occupational rhinitis induced by molds.
  
  
  METHODS
  Nasal provocation test (NPT) with commercial fungal allergens was performed in 369 patients during 1995-2004 at the Finnish Institute of Occupational Health. Of these, 60 (16%) were positive. In addition to positive NPT, the diagnosis of occupational rhinitis was based on verified exposure to molds, work-related nasal symptoms, and clinical investigations. We wanted to review the patient files of these 60 patients retrospectively, and 56 patients gave their informed consent.
  
  
  RESULTS
  The mean age of the patients was 43.7 years (SD +/- 9.5). Fifty (89.3%) patients were women. In 23% of the patients, IgE-mediated allergy to molds could be established. Atopy significantly increased IgE sensitization to molds (OR, 10.3 [95% CI, 2.0-52.5]). The most common mold to induce occupational rhinitis was Aspergillus fumigatus. Exposure time was over 5 years in 63% of the patients. Association between the IgE sensitization to molds and exposure level was statistically significant (Fisher's exact test, p = 0.046).
  
  
  CONCLUSIONS
  This is the first clinically investigated series on occupational rhinitis in relation to a moldy environment. Based on our findings, we conclude that molds growing in conjunction with moisture damages can induce occupational rhinitis. IgE-mediated allergy to molds was not common. Atopy and significant exposure level increased IgE sensitization to molds. zri00508.
authors.affiliation: Occupational Medicine Team, Finnish Institute of Occupational Health, Helsinki, Finland. kirsi.karvala@ttl.fi
authors.forename: Kirsi
authors.initials: K
authors.lastname: Karvala
authors.forename: Henrik
authors.initials: H
authors.lastname: Nordman
authors.forename: Ritva
authors.initials: R
authors.lastname: Luukkonen
authors.forename: Elina
authors.initials: E
authors.lastname: Nykyri
authors.forename: Sanna
authors.initials: S
authors.lastname: Lappalainen
authors.forename: Timo
authors.initials: T
authors.lastname: Hannu
authors.forename: Elina
authors.initials: E
authors.lastname: Toskala
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D000908:Antibodies, Fungal / Q000276:immunology; D001228:Aspergillosis / Q000175:diagnosis / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000276:immunology / Q000302:isolation & purification; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D009299:Nasal Provocation Tests; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D016273:Occupational Exposure / Q000009:adverse effects*; D012189:Retrospective Studies; D012220:Rhinitis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D012307:Risk Factors
chemical_list: D000888:Antibodies, Anti-Idiotypic; D000908:Antibodies, Fungal; D007073:Immunoglobulin E